Case #155 – May, 2005

An 8-year-old boy complained of bloating and intermittent diarrhea, and he told his mother he had passed a worm when he went to the bathroom. They went to a physician and reported that the boy had a history of chronic stomach problems and gastrointestinal reflux. No travel history or date of symptom onset was given. The physician ordered an ova and parasite (O & P) examination. A stool specimen was collected at a local medical facility and submitted for testing. Figures A and B show objects that were seen on a wet mount smear, at 100× and 200× magnification respectively, from an FEA concentration performed at the California State Department of Health Services laboratory. What is your diagnosis? Based on what criteria?

Figure A

Figure B

The objects in this case are artifacts (plant hairs) which may be confused with nematode larvae, and a diagnosis was made of No Parasites Found (NPF). The objects lacked internal structures, such as a digestive or reproductive tract. There appeared to be a tube or canal that runs almost the entire length of the objects, but it is refractile with no identifiable changes representing an esophagus, intestine, etc. A true digestive tract would not appear refractile and would have clearly identifiable components. The objects also lacked any discernable external structures such as a mouth, lips, or papilliae, etc.